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Get Alvernia University PDU Verification Form

Once you have completed the form send it to Linda Marburger, OT Secretary at Linda.marburger@alvernia.edu or mail completed copy. A certificate will be generated verifying your supervision and mailed directly to you. Thank you for your time and assistance in this process. FIELDWORK SITE NAME: FIELDWORK SUPERVISOR: (S) DATES OF SUPERVISION: ALVERNIA UNIVERSITY STUDENT: PLEASE CHECK ONE:  LEVEL I  LEVEL II ADDRESS WHERE CERTIFICATE SHOULD BE SENT OR EMAIL: .

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